There continues to be confusion and misinformation abounding in Florida on the issue of federal Medicaid funding. This year the state is giving up approximately $5 billion in federal funds that are available under the Affordable Care Act to extend Medicaid coverage to uninsured Floridians at no cost to the state. The only reason that this $5 billion in federal money is not flowing to Florida today is because the state has not agreed to accept it.

Separately, the state has a very unusual arrangement with the federal government called the Low Income Pool, which predates the ACA and reflects an agreement for special funding originally negotiated between then President George Bush and former Florida Governor Jeb Bush through a Medicaid Section 1115 waiver. This special deal is not available to most states and it has come under scrutiny by the GAO and others.

The federal government has been clear for some time that the LIP would not be renewed “as is” given the dramatic changes in the health coverage landscape and problems with the LIP. The state continued to maintain that nothing needed to change despite abundant evidence to the contrary.

Nobody in the state should be surprised that that LIP money will not continue at its current levels. Certainly regular readers of SayAhhh! know that is not the case – I have been saying so since CMS extended the LIP piece of the waiver for only one year while extending the rest of the waiver for a three-year period.

There should be no doubt that the smarter and more reliable path from a fiscal and economic perspective, as well as a surefire way to reduce the state’s extremely high uninsured rate, is to accept the ACA expansion funds.

The clock is ticking in the Florida legislature where budget decisions need to be made. Health care for 800,000 Floridians is at stake and this is a matter of enormous consequence. Let’s hope that Florida policymakers make the responsible fiscal choice and act in the best interests of their constituents by accepting the Medicaid funding.